Healthy Marriage and Responsible Fatherhood Initiative:

Further Progress Is Needed in Developing a Risk-Based Monitoring Approach to Help HHS Improve Program Oversight

GAO-08-1002: Published: Sep 26, 2008. Publicly Released: Oct 27, 2008.

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Strengthening marriages and relationships in low-income families has emerged as a national strategy for enhancing the well-being of children. The Deficit Reduction Act of 2005 (DRA) appropriated $150 million in discretionary grants each year from 2006 through 2010 to implement the Healthy Marriage and Responsible Fatherhood Initiative. To provide insight into how these programs are being implemented and monitored, GAO is reporting on (1) how the Department of Health and Human Services (HHS) awarded grants and the types of organizations that received funding; (2) what activities and services grantees are providing, including those for domestic violence victims; (3) how HHS monitors and assesses program implementation and use of funds; and (4) how program impact is measured. GAO surveyed grantees, interviewed HHS staff, reviewed HHS records and policy, and visited several programs.

Operating under a deadline that allowed HHS 7 months to award grants, HHS shortened its existing process to award Healthy Marriage and Responsible Fatherhood grants to public and private organizations. During this process, HHS did not fully examine grantees' programs as described in their applications, including the activities they planned to offer, and this created challenges and setbacks for grantees later as they implemented their programs. For example, some grantees told us that they were informed that certain activities were not permitted months into program implementation even though HHS had approved these same activities described in their grant applications. The Healthy Marriage and Responsible Fatherhood programs provide similar activities, but their focus and target populations differ. Healthy Marriage programs are more likely to provide marriage and relationship activities, while Responsible Fatherhood programs are more likely to provide parenting skills. Additionally, both programs serve low-income and minority groups, but Healthy Marriage grantees are more likely to target teenaged youth, and Responsible Fatherhood grantees are more likely to target incarcerated parents. Both programs' grantees reported that they refer domestic violence victims to specialists in their communities. HHS uses methods that include site visits and progress reports to monitor grantees, but it lacks mechanisms to identify and target grantees that are not in compliance with grant requirements or are not meeting performance goals, and it also lacks clear and consistent guidance for performing site monitoring visits. Moreover, HHS's ability to readily identify which grantees are not in compliance or not meeting goals is hindered because it currently lacks uniform performance indicators and a computerized management information system that would enable HHS to more efficiently track key information on individual grantees. HHS told us that it is in the process of developing a management information system and has submitted uniform performance indicators for review. HHS has established a rigorous research agenda to gauge the long-term impact of healthy marriage and responsible fatherhood activities on diverse, low-income populations. HHS is sponsoring three multiyear impact evaluations of the Healthy Marriage program and one of the Responsible Fatherhood program.

Status Legend:

More Info
  • Review Pending-GAO has not yet assessed implementation status.
  • Open-Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.
  • Closed-implemented-Actions that satisfy the intent of the recommendation have been taken.
  • Closed-not implemented-While the intent of the recommendation has not been satisfied, time or circumstances have rendered the recommendation invalid.
    • Review Pending
    • Open
    • Closed - implemented
    • Closed - not implemented

    Recommendations for Executive Action

    Recommendation: In order to improve monitoring and oversight of Healthy Marriage and Responsible Fatherhood grantees, the Secretary of HHS should employ a risk-based approach to monitoring grantees and conducting grantee site visits, using its planned management information system and information from both progress reports and uniform performance indicators to help identify those grantees at risk of not meeting performance goals or not in compliance with grant requirements.

    Agency Affected: Department of Health and Human Services

    Status: Closed - Implemented

    Comments: HHS agreed with our recommendation to employ a risk-based approach to monitoring, using its planned management information system (MIS) and performance indicators to help identify grantees for monitoring and noted that these tools would further enhance oversight and monitoring efforts currently underway. HHS officials reported in September 2010 that its web-based management system was fully operational. The MIS includes a Document Management System and a Risk Management Module. According to officials, both components are designed to enhance monitoring and oversight capabilities, including risk-assessment, of the Healthy Marriage and Responsible Fatherhood programs. Officials reported that they have developed a customized approach to prioritizing site visits and technical assistance and will periodically revise their policies and practices as appropriate.

    Recommendation: In order to improve monitoring and oversight of Healthy Marriage and Responsible Fatherhood grantees, the Secretary of HHS should create clear, consistent guidance and policy for monitoring Healthy Marriage and Responsible Fatherhood grantees.

    Agency Affected: Department of Health and Human Services

    Status: Closed - Implemented

    Comments: According to HHS officials, upon further review, they agreed with this recommendation and revised their site visit protocol. Additionally, they have provided additional training to staff on an ongoing basis.

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